From the design of the Kashmir, Dera Ismail Khan and Bannu hospitals to the Peshawar, Multan, Islamabad, Isfahan, Kerman and Yazd hospitals, there were continuities, varieties, differences, as well as innovations. As I explained, these varieties and innovations mean that we need to expand our understanding of British hospital architecture in the nineteenth and early twentieth centuries. Besides, what do these variations and innovations tell us about the relationship between missionary medicine and empire? More specifically, could missionaries’ agenda to gain trust overlap with the interests of ‘the state’? This chapter addresses this question. A statement by Lord Frederick Roberts, which was made probably sometime in the 1900s, regarding Dr Theodore Pennell would be a good starting point: ‘Dr Pennell is worth a couple of regiments to the British on that frontier any day’. This statement interested missionaries; they referred to it in their reports, extending it at times to include all the medical missionaries who worked in north-western British India. Lord Roberts was one of the most successful British military commanders, famous for his service in both British India and South Africa. Concerning north-western British India, he is known for his standpoint and actions regarding Anglo-Russian rivalry that lasted intermittently from approximately 1807 until 1914. In using the word ‘regiments’, Roberts associated or even equated the missionaries with his troops in the struggle against Russia. The missionaries’ interest in this declaration suggests that they presented (if not partly perceived) their work as an essential component of the British Indian defence.

This chapter will shed some light on how the missionaries presented their efforts to gain trust in the context of Anglo-Russian rivalry. Eighteen years after Jeffrey Cox warned against ‘the marginality of missionaries in narratives of the imperial enterprise’, missionaries are now one of the main preoccupations in the ‘mainstream imperial history and literature’. However, the same cannot be said about the narratives of Anglo-Russian rivalry, where the missionaries are still marginalised or ignored altogether, in favour of those judged to be central to the rivalry: scholars, military officers, imperial administrators and travellers. This makes defining a point of view from which to tell the story challenging, and this chapter by no means claims to provide an all-inclusive examination.